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Thromb Haemost 2000; 83(01): 10-13
DOI: 10.1055/s-0037-1613748
Commentary
Schattauer GmbH

Elevation of FVIII: C in Venous Thromboembolism Is Persistent and Independent of the Acute Phase Response

James O’Donnell
1   From the Department of Haematology, Imperial College School of Medicine/Hammersmith Hospital, London, UK
,
Andrew D. Mumford
2   MRC Haemostasis Research Group, London, UK
,
Richard A. Manning
1   From the Department of Haematology, Imperial College School of Medicine/Hammersmith Hospital, London, UK
,
Michael Laffan
1   From the Department of Haematology, Imperial College School of Medicine/Hammersmith Hospital, London, UK
› Author Affiliations
Further Information

Publication History

Received 26 May 1999

Accepted after resubmission 30 August 1999

Publication Date:
06 December 2017 (online)

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Summary

Recent literature has suggested a role for elevated FVIII:C in venous thromboembolic disease (VTED). However since FVIII:C is known to rise in response to an acute phase reaction, it is difficult to determine whether the increased FVIII:C precedes the thrombosis or represents a secondary reactive phenomenon. In an attempt to address this question, we followed 35 patients with confirmed VTED, raised FVIII:C level (>1.5 iu/ml) and no other thrombotic tendency. Serial measurements of FVIII:C, vWF:Ag, C-reactive protein and fibrinogen were performed. We hypothesized that a persistent increase in FVIII:C in the absence of any other measures of ongoing acute phase response, would support the idea that elevation of FVIII:C is a constitutional phenomenon.

Of this initial group, 94% continued to have an elevated FVIII:C level throughout the period of follow up (median 8 months; range 3 to 39 months), with no significant difference between the FVIII:C levels determined at first estimation and those obtained during follow up (p = 0.58). Conversely, only 18% had evidence of an acute phase reaction when first assessed, and nonparametric ranking analysis demonstrated no correlation between FVIII:C and either C-reactive protein or fibrinogen (p = 0.315 and 0.425 respectively).We conclude that increased FVIII:C levels following VTED are persistent, independent of the acute phase reaction, and thus may represent a constitutional risk factor for VTED.

Keywords

FVIII:C - venous thromboembolism - acute phase
 

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